Obstructive uropathy due to interstitial cystitis in a patient with systemic lupus erythematosus

A patient with documented SLE is described who presented with dysuria, gastrointestinal (GI) symptoms and renal insufficiency associated with the unusual occurrence of bilateral hydro-ureteronephrosis due to ureterovesical junction stricture (obstructive uropathy) on radiographic findings. Pathologic investigations disclosed chronic interstitial cystitis (IC) with evidence of focal immune complex deposition in blood vessel walls of the bladder. The GI symptoms and dysuria regressed with initial therapy of SLE by steroid but persistent obstructive uropathy (OU) and renal insufficiency required bilateral nephrostomy. Then, following continuous medical treatment with steroid plus intravenous pulse injection of cyclophosphamide, obstructive uropathy was relieved even with removing nephrostomy tube and renal function remained stable.